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[Effect of stepwise hypervolemic versus isovolemic hemodilution in patients with intermittent claudication on muscle
H G Höffkes1, K Saeger-Lorenz, A M Ehrly
1Abteilung für Angiologie, Universitätsklinikums, Frankfurt am Main.
In patients with intermittent claudication and concomitant high hematocrit values a stepwise hypervolemic hemodilution versus isovolemic hemodilution (intravenous infusion of 500ml 10% hydroxyethylstarch solution (HES)(mean molecular weight 200.000/substitution degree 50%) or vensection and subsequent infusion of 10% HES (200/0.5)) were performed intraindividually. Measurements of muscle tissue oxygen pressure (pO2) values using a standardized pedalergometric exercise test as well as the pain free walking distance using a standardized treadmill were performed. Optimal results of muscle tissue oxygen pressure (pO2) behaviour after pedalergometric exercise test as well as muscular performance on the treadmill were found using isovolemic hemodilution at an average hematocrit value of 40.60%. In contrast, hypervolemic hemodilution at a comparable hematocrit level (40.50%) induced a "retarded reactive hyperoxia" and only a moderate increase of painfree walking distance.
In patients with intermittent claudication and concomitant high hematocrit values a stepwise hypervolemic hemodilution versus isovolemic hemodilution (intravenous infusion of 500ml 10% hydroxyethylstarch solution (HES)(mean molecular weight 200.000/substitution degree 50%) or vensection and subsequent infusion of 10% HES (200/0.5)) were performed intraindividually. Measurements of muscle tissue oxygen pressure (pO2) values using a standardized pedalergometric exercise test as well as the pain free walking distance using a standardized treadmill were performed. Optimal results of muscle tissue oxygen pressure (pO2) behaviour after pedalergometric exercise test as well as muscular performance on the treadmill were found using isovolemic hemodilution at an average hematocrit value of 40.60%. In contrast, hypervolemic hemodilution at a comparable hematocrit level (40.50%) induced a "retarded reactive hyperoxia" and only a moderate increase of painfree walking distance.